Interventions to increase personal protective behaviours to limit the spread of respiratory viruses: A rapid evidence review and meta-analysis

Purpose: Changing human behaviour is critical for stopping the spread of respiratory viruses, including SARS-CoV-2. This includes increasing personal protective behaviours: we need evidence to inform how to achieve this. We aimed to evaluate the acceptability, practicability, effectiveness, affordability, spill-over effects and equity impact of interventions to increase personal protective behaviours to limit the spread of respiratory viruses. / Methods: We used standard best practice for rapid evidence reviews. We searched Ovid MEDLINE and Scopus to identify interventions designed to change six personal protective behaviours: hand hygiene; avoiding touching the ‘T-Zone’; catching droplets in tissues; face mask use; disinfecting surfaces; and maintaining physical distancing. Primary research studies conducted in adults or children with active or passive comparators were included. A narrative synthesis and random-effects meta-analyses were conducted. / Results: We identified 39 studies conducted across 15 countries. Interventions targeted hand hygiene (n = 30) and/or face mask use (n = 12) and used two- or three-arm study designs with passive comparators. Interventions were typically delivered face-to-face and included a median of three behaviour change techniques. Interventions to increase hand hygiene had a medium, positive effect (d = 0.62, 95% CI = 0.43-0.80, p < .001, I2 = 81.2%). Interventions targeting face mask use had mixed results, with an imprecise pooled estimate (OR = 4.14, 95% CI = 1.24-13.79, p < .001, I2 = 89.67%). Between-study heterogeneity was high. / Conclusions: We found positive effects of interventions targeting hand hygiene, with unclear results for interventions targeting face mask use